Melanoma Prevention: Comparison of Different Screening Methods for the Selection of a High Risk Population.

Nevio Dubbini,Pietro Massei,Antonella Romanini,Andrea Nannipieri,Stefano Malloggi,Marco Celli,Giovanni Menchini,Laura Ricci,Serena Gianfaldoni,Maurizia Ghilardi,Antonella Puddu,Giuseppe Ferraùto,Grazia Salimbeni,Roberto Gianfaldoni,Tommaso Rubino,Daniele Gandini

doi:10.3390/ijerph18041953

Abstract

Background: Guidelines recommend limiting melanoma screening in a population with known risk factors, but none indicates methods for efficient recruitment. The purpose of this study is to compare three different methods of recruiting subjects to be screened for melanoma to detect which, if any, is the most efficient. Methods: From 2010 to 2019, subjects were recruited as follows: (1) regular skin examinations (RS), mainly conducted through the Associazione Contro il Melanoma network; (2) occasional melanoma screening (OS), during annual public campaigns; (3) and selective screening (SS), where people were invited to undergo a skin check after filling in a risk evaluation questionnaire, in cases where the assigned outcome was intermediate/high risk. Melanoma risk factors were compared across different screening methods. Generalized Linear Mixed Models were used for multivariable analysis. Results: A total of 2238 subjects (62.7% women) were recruited, median age 44 years (2–85), and 1094 (48.9 %) records were collected through RS, 826 (36.9 %) through OS, and 318 (14.2 %) through SS. A total of 131 suspicious non-melanoma skin cancers were clinically diagnosed, 20 pathologically confirmed, and 2 melanomas detected. SS performed significantly better at selecting subjects with a family history of melanoma and I-II phototypes compared to OS. Conclusions: Prior evaluation of melanoma known risk factors allowed for effective selection of a population to screen at higher risk of developing a melanoma.

Highlights

The incidence of malignant melanoma varies from 0.003% to 0.005% per year in Mediterranean countries, and from 0.012% to 0.020% per year in Northern European countries [1]
2010 to June 2016; Selective screening (SS) information campaigns held for 2 weeks yearly where persons were evaluated for the risk of developing melanoma through a quick questionnaire using 10 questions and adapted from the Australian Victorian Melanoma Service
Skin examination appointments were scheduled in advance, and participants signed a disclaimer form, which was notified to the local ethical committee

Summary

Introduction

The incidence of malignant melanoma varies from 0.003% to 0.005% per year in Mediterranean countries, and from 0.012% to 0.020% per year in Northern European countries [1]. Melanoma age-adjusted overall incidence per 100,000 person-years has increased in the past 30 years, from 13.94 to 21.87 from 1989–1991 to 2007–2009 in the 4.0/). Guidelines recommend limiting melanoma screening in a population with known risk factors, but none indicates methods for efficient recruitment. The purpose of this study is to compare three different methods of recruiting subjects to be screened for melanoma to detect which, if any, is the most efficient. Regular skin examinations (RS), mainly conducted through the Associazione Contro il Melanoma network; (2) occasional melanoma screening (OS), during annual public campaigns; (3) and selective screening (SS), where people were invited to undergo a skin check after filling in a risk evaluation questionnaire, in cases where the assigned outcome was intermediate/high risk. Melanoma risk factors were compared across different screening methods. Results: A total of 2238 subjects (62.7% women) were recruited, median age 44 years (2–85), and 1094 (48.9 %) records were collected through RS, 826 (36.9 %) through

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